Can telemedicine be effective in responding to local health needs? Insights from the experience of Piedmont Region in Italy

ABSTRACTBackgroundWhile Community Needs Assessments (CNAs) are an important tool for Student-Run Clinics (SRCs) to understand local communities’ healthcare needs, few studies have evaluated CNAs and their impact on care provided at SRCs.ObjectiveEvaluate results from two CNAs of an SRC in East Parkside, Philadelphia to better comprehend (1) community awareness and opinions regarding the SRC and (2) local healthcare concerns and access.Methods58 and 105 East Parkside residents were surveyed in 2011 and 2015 respectively. The results were analyzed to quantify various health-related measures in the community.ResultsResults showed high rates of hypertension, asthma, and diabetes. Rates of pap-smear and hypertension screening matched national averages while mammograms and colonoscopies were below national rates. Both CNAs showed that less than 40% of community members were aware of the clinic’s existence.ConclusionsCNAs can provide valuable insights regarding local health needs which can inform future healthcare interventions.

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Accountable Care Organizations and Clinical Commissioning Groups face an uncertain challenge for improving public health

Journal of Public Health Research ◽

10.4081/jphr.2012.e16 ◽

2012 ◽

Vol 1 (2) ◽

pp. 16

Author(s):

Douglas J. Noble

Keyword(s):

Public Health ◽

Health Services ◽

Population Health ◽

The United States ◽

Accountable Care Organizations ◽

Health Needs ◽

Local Health ◽

Accountable Care ◽

The Usa ◽

The Uk

<p>Accountable Care Organizations (ACO) in the United States of America (USA) and Clinical Commissioning Groups (CCG) in the United Kingdom (UK) are new proposed organizations in health services both tasked with a role which includes improving public health. Although there are very significant differences between the UK and USA health systems there appears to be a similar confusion as to how ACO and CCG will regard and address public or population health. The role of ACO in improving population health and evaluating the health needs of their registered and insured patients remains ill-defined and poorly explored. Likewise, in the current UK National Health Service (NHS) reorganisation, control and commissioning of appropriate local health services are passing from Primary Care Trusts (PCT) to new cross-organizational structures (CCG). CCG groups aim to be, like ACO, physician led. They will also assume a role for public or population health, but this role, like that of the newly-forming ACO, is currently unclear. Lessons learned from the USA and UK experience of new organizations tasked with a role in improving public health may inform mechanisms for physician led organizations in the UK and the USA to assess health needs, monitor population health information and improve population health outcomes.</p>

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Can a Different Formulation of Vitamin D3 Allow Savings? An Analysis From an Italian Regional Perspective

Health Services Research and Managerial Epidemiology ◽

10.1177/2333392819861881 ◽

2019 ◽

Vol 6 ◽

pp. 233339281986188

Author(s):

Mario Sanò ◽

Patrizia Dutto ◽

Stefano D’Anna ◽

Carla Rognoni

Keyword(s):

Health Care ◽

Vitamin D3 ◽

Pharmaceutical Expenditure ◽

Local Health Authority ◽

Local Health ◽

Pharmaceutical Spending ◽

Reducing Costs ◽

New Formulation ◽

Average Expenditure ◽

Piedmont Region

Vitamin D3 reported in Italy in 2017 the net expenditure of almost €180 million, reaching the first place for consumption and the third place for conventional pharmaceutical spending. The aim of the study was to evaluate whether a shift of vitamin D3 prescriptions toward 100 000 IU formulation, less costly, could allow savings from the health-care perspective. An approach promoting the prescription of this formulation has been applied in a local health authority (ASL CN2) in Piedmont Region (Italy) starting from 2015. The retail pharmaceutical market and the consumption of vitamin D3 has been analyzed from year 2014 to 2017 in order to evaluate differences in expenditures. Despite an increase in consumption, the introduction of the new formulation enabled ASL CN2 to save about €280 000 in 2017 considering the regional average expenditure per 1000 inhabitants as a reference. If Piedmont Region had presented an average expenditure in line with that of ASL CN2, the annual regional savings would have exceeded €7 million in 2017 alone. A shift of vitamin D3 prescriptions toward 100 000 IU formulations would allow reducing costs from the payer perspective. Savings may be used to contain public pharmaceutical expenditure or can be allocated to fund other health-care technologies and services.

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Pharmacists’ Utilization of Information Sources Related to Community and Population Needs in the Upper Midwest and Associations with Continuing Professional Education

Pharmacy ◽

10.3390/pharmacy7030125 ◽

2019 ◽

Vol 7 (3) ◽

pp. 125

Author(s):

Paul Henkel ◽

Marketa Marvanova

Keyword(s):

Professional Education ◽

Health Professionals ◽

Rural Areas ◽

Information Sources ◽

Continuing Professional Education ◽

Population Based ◽

Health Needs ◽

Local Health ◽

County Level ◽

Community Changes

Background: To investigate information sources utilized in pharmacists’ assessment of population-based health needs and/or community changes; and the association between information sources utilized and reported completion of continuing professional education topics. Methods: In 2017; licensed pharmacists (n = 1124) in North Dakota; South Dakota; Minnesota; Iowa; and Nebraska completed a questionnaire on continuing professional education and information sources on population-based health needs and community changes. Data were entered; cleaned and imported into Stata 11.1. Census Bureau county-level population density data were used to classify local area characteristics. Descriptive statistics and multivariate logistic regression analyses were performed. Results: Most sources of primary; county-level data on population-based health needs or community changes were minimally utilized. Pharmacists in more rural areas were statistically more likely to use local health professionals; local non-health professionals; and/or the state health department compared to pharmacists in less rural areas. Pharmacists reporting higher use of population-based information sources were more likely to have completed continuing education in the past 12 months for all 21 surveyed topics; 13 significantly so. Conclusions: There is a reliance of pharmacists on information from local health and non-health professionals for information on population-based health needs and/or community changes. Utilization of health departments and other primary information sources was associated with increased rates of completion of an array of continuing professional education topics. Expanding utilization of evidence-driven information sources would improve pharmacists’ ability to better identify and respond to population-based health needs and/or community changes through programs and services offered; and tailor continuing professional education to population-based health needs.

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Asylum seekers’ healthcare in Italy: policies and practices among different regions

European Journal of Public Health ◽

10.1093/eurpub/ckz186.075 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Milani ◽

J Bianchi ◽

P Bordin ◽

S Bortoluzzi ◽

V Gianfredi ◽

...

Keyword(s):

Continuity Of Care ◽

Asylum Seekers ◽

Health Workers ◽

Health Needs ◽

Local Health ◽

Refugee Status ◽

The Real ◽

Italian Law ◽

Computerized System ◽

Policies And Practices

Abstract Background The Italian law provides for international protection and universal health-care coverage for asylum seekers (AS). Indeed, they are entitled to be regularly registered at the National Healthcare Service. Before submitting the application for refugee status, medical assistance to migrants is up to local administration. Our aim was to describe and compare policies and protocols regulating AS healthcare from their arrival to their application for refugee status, at national and regional level. Moreover, we investigated the daily healthcare practice addressing potential gaps between policies and practice. Methods The research team is a subgroup of the Inequality working group of the Italian hygiene society and it is composed of public health residents. The research involved also local health workers and other professionals belonging to regional groups of Italian migrant medicine society (SIMM). We collected national, regional and local policies and protocols and we compared them using a specific framework. Furthermore, we achieved a mapping of daily practice implementation at local health organization (LHO) level using a checklist. Results The most relevant findings were that regional policies themselves vary notably from each other and, as regard practices, LHO implement differently the same regional legislation. Furthermore, we found some critical issues: the delayed inclusion in primary care assistance and lack of continuity of care and of a computerized system of recording information. Conclusions The lack of uniformity concerning policies and practices of AS healthcare might also result in unawareness and uncertainty about how to access to healthcare services by migrants. An enhanced cooperation between groups dealing with migrants’ issues may lead to avoid variability at the implementation. Finally, a computerized system for data collection might facilitate the continuity of care and the assessment of the real health needs of the AS population. Key messages It is a priority challenge for health systems to strengthen the interventions aimed at overcoming the linguistic, economic, cultural and administrative barriers to the health services access. It is crucial to improve the recording information system to detect the real health needs of AS, their change and the inequalities in access and to improve collaboration between groups and university.

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Rebuilding a US Federal Data Strategy After the End of the “Community Health Status Indicators”

American Journal of Public Health ◽

10.2105/ajph.2021.306437 ◽

2021 ◽

Vol 111 (10) ◽

pp. 1865-1873

Author(s):

Robert L. Phillips ◽

Norma F. Kanarek ◽

Vickie L. Boothe

Keyword(s):

Health Status ◽

Community Health ◽

Health Resources ◽

Health Status Indicators ◽

Health Needs ◽

National Committee ◽

Local Health ◽

Peer Community ◽

New Community ◽

Community Health Status

For nearly 2 decades, the Community Health Status Indicators tool reliably supplied communities with standardized, local health data and the capacity for peer-community comparisons. At the same time, it created a large community of users who shared learning in addressing local health needs. The tool survived a transition from the Health Resources and Services Administration to the Centers for Disease Control and Prevention before being shuttered in 2017. While new community data tools have come online, nothing has replaced Community Health Status Indicators, and many stakeholders continue to clamor for something new that will enable local health needs assessments, peer comparisons, and creation of a community of solutions. The National Committee on Vital and Health Statistics heard from many stakeholders that they still need a replacement data source. (Am J Public Health. 2021;111(10):1865–1873. https://doi.org/10.2105/AJPH.2021.306437 )

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Using Geographic Information Systems to Match Local Health Needs With Public Health Services and Programs

American Journal of Public Health ◽

10.2105/ajph.2011.300195 ◽

2011 ◽

Vol 101 (9) ◽

pp. 1664-1665 ◽

Cited By ~ 21

Author(s):

Tamara Dubowitz ◽

Malcolm Williams ◽

Elizabeth D. Steiner ◽

Margaret M. Weden ◽

Lisa Miyashiro ◽

...

Keyword(s):

Public Health ◽

Information Systems ◽

Geographic Information Systems ◽

Health Services ◽

Geographic Information ◽

Health Needs ◽

Local Health ◽

Public Health Services

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Realising the potential of health needs assessments

Australian Health Review ◽

10.1071/ah16262 ◽

2018 ◽

Vol 42 (4) ◽

pp. 370 ◽

Cited By ~ 1

Author(s):

Matthew Anstey ◽

Paul Burgess ◽

Lisa Angus

Keyword(s):

Social Services ◽

Data Exchange ◽

Health Sector ◽

Population Level ◽

Health Department ◽

Health Needs ◽

Local Health ◽

Local Conditions ◽

Community Needs ◽

Needs Assessments

Population-level assessment and planning has traditionally been the role of public health departments but in establishing Primary Health Networks (PHNs), the Australian Government has instituted a new mechanism for identifying community needs and commissioning services to meet those needs. If PHNs are to achieve the vision of nimble organisations capable of identifying and addressing local health needs via integrated health and social services, several things need to occur. First, PHN funding schedules must become more flexible. Second, the Federal health department must maintain an open dialogue with PHNs, permit waivers in funding schedules to suit local conditions and be prepared to back innovations with seed investment. Third, health data exchange and linkage must be accelerated to better inform community needs assessments and commissioning. Finally, PHNs must be encouraged and supported to develop collaborations both within and outside the health sector in order to identify and address a broad set of health issues and determinants. By following these principles, PHNs may become leading change agents in the Australian healthcare system.

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